Perioperative Management of Antiphospholipid Antibody Positive Patients During Noncardiac Surgeries

  • Katherine H. Saunders
  • Doruk Erkan


Antiphospholipid syndrome (APS) is defined as vascular thrombosis and/or pregnancy morbidity in patients with persistently positive antiphospholipid antibodies (aPL) (Table 8.1) [1]. Catastrophic APS is a rare but rapidly progressive life-threatening form of APS that causes multiple organ thromboses, generally associated with small vessel involvement [2]. The most commonly used tests to detect aPL are lupus anticoagulant (LA) test (a functional coagulation assay), anticardiolipin antibody (aCL) enzyme-linked immunosorbent assay (ELISA), and anti-β2-glycoprotein-I antibody (aβ2GPI) ELISA. Antiphospholipid syndrome can occur in otherwise healthy individuals without underlying autoimmune disease (primary APS) or in patients with other systemic autoimmune diseases, particularly systemic lupus erythematosus (SLE). Stroke is the most common arterial manifestation, and deep vein thrombosis (DVT) is the most common venous manifestation of APS. The presence of aPL without characteristic clinical complications does not indicate APS, and asymptomatic (no history of vascular or pregnancy events) aPL-positive patients exist.


Antiphospholipid antibodies Antiphospholipid syndrome Thrombosis Anticoagulation 


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© Springer Science+Business Media, LLC 2013

Authors and Affiliations

  1. 1.New York-Presbyterian HospitalNew YorkUSA
  2. 2.The Barbara Volcker Center for Women and Rheumatic Disease, Hospital for Special Surgery, Weill Medical College of Cornell UniversityNew YorkUSA

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